A pragmatic video intervention to promote African American organ donor registration at the Department of Motorized Vehicles Abstract Rationale: There are 122,000 persons waiting for donor organs in the US, but only about 30,000 transplants are performed each year. The Department of Health and Human Services has set the goal that at least 50% of adults in each state become registered organ donors. Increasing donor registration is important with passage of first-person consent laws in all 50 states. First-person consent makes the indication of an adult's intent to donate organs (i.e. becoming a registered donor) legally binding, much like a living will. In Alabama, 77% of Caucasians are registered organ donors, but only 28% of African Americans are registered organ donors. There is need for persuasive educational interventions to increase African American organ donor registration. Objectives: Over 97% of organ donor registrations (for all races) occur at the Department of Motorized Vehicles (DMV), making this the obvious intervention venue to increase donor registration. A series of studies of African Americans that recently visited a DMV in Alabama and made the decision (yes or no) to become a registered donor was conducted through the PIs current K23 Career Development Award. Most African American participants who decided not to become a registered donor stated they had not considered becoming a registered donor prior to being asked, and the safe answer was no. To increase African American donor registration, participants advocated presenting organ donor information on flat screen TVs while standing in line at the DMV, and prioritized organ donor topics for the educational video. Building on these preliminary findings, the goal of the proposed study is to pilot a video intervention at the DMV to promote African American donor registration. The pilot project will be conducted during years 4 and 5 of the K23. Design and Methods: The five Birmingham, Alabama area DMVs will be used for the pilot video intervention. Each DMV services a high proportion of African Americans. The Organ Donation Model will be used as the theoretical framework to help ensure that intervention is persuasive and effective. African American organ donor educational topics identified as most important through the PIs current K23 will be used to create a video storyboard. The video storyboard will be tested and modified based upon the results of audience research. A series of video narratives will be developed. The video narratives will then be further tested and modified with audience research. The final product will be a repeating 10-15 minute video intervention promoting the positive aspects of African American organ donor registration, presented via flat screen TVs to persons at the DMV. A randomized cross-over design using DMV facility as the unit of randomization will measure if the intervention increases African American donor registration when the video is playing compared to when the video is off. Significance: The developed video content and efficacy data will serve the basis of a future R01 rolling out this intervention on a larger scale in the South. f effective, the DMV-based flat screen TV intervention may be utilized for other populations with low organ donor registration rates.